Sleep Paralysis in Narcolepsy
Sleep paralysis is a feeling of being conscious but unable to move. It occurs when a person passes between stages of wakefulness and sleep. During these transitions, you may be unable to move or speak for a few seconds up to a few minutes. Some people may also feel pressure or a sense of choking. Sleep paralysis may accompany other sleep disorders such as narcolepsy. Narcolepsy is an overpowering need to sleep caused by a problem with the brain's ability to regulate sleep.
Quick GuideSleep Disorders: Insomnia, Sleep Apnea, and More
- Narcolepsy is a chronic disease of the central nervous system. Symptoms include excessive daytime sleepiness (EDS), sudden loss of muscle tone (cataplexy),
distorted perceptions (hypnagogic hallucinations), inability to
move or talk (sleep paralysis), disturbed nocturnal sleep, and
- Narcolepsy usually begins in
teenagers or young adults and affects both sexes equally.
- Abnormalities in the structure and function of a
particular group of nerve cells in the brain
called hypocretin neurons are thought to play a role in the development of narcolepsy.
- The diagnosis of
narcolepsy is based on a clinical evaluation,
specific questionnaires, sleep logs or diaries, and the
results of sleep
laboratory tests (polysomnography and multiple sleep latency test).
- Treatment options for narcolepsy include drug and behavioral
modification therapies and
disease-specific education of the patient and family members. The treatment is individualized, depending on the types and severity of the
symptoms, the life
conditions of the patients, and the specific goals of therapy.
- Optimal management usually takes weeks to months to achieve and requires
communication among the physician, patient, family members, and others.
- Alerting medications are used for the treatment of excessive daytime
Amphetamines and methylphenidate (Ritalin) are
general CNS stimulants that decrease
sleepiness and improve alertness. Modafinil (Provigil)
and armondafinil (Nuvigil) have alerting effects similar to
those of the
traditional stimulants but has less undesirable side effects.
- Anticataplectic medications are used to treat cataplexy, hypnagogic hallucinations, and sleep
paralysis. Tricyclic antidepressants
(TCAs) are often effective in controlling cataplexy, but also frequently produce side effects that limit their use.
- Selective serotonin reuptake
(SSRIs) are also useful in the treatment of cataplexy and their side effects are milder. Sodium oxybate (Xyrem) is a medication with anticataplectic effects that
also improves disturbed nocturnal sleep.
- Behavioral approaches to treating narcolepsy include establishing a structured sleep-wake cycle and planned naps,
and involve diet, exercise, and occupational, marriage, and family
What is narcolepsy?
Narcolepsy is a chronic disease of the central nervous system. Excessive daytime sleepiness
(EDS) is the main symptom and is present in 100% of patients with
narcolepsy. Other primary symptoms of narcolepsy include:
- loss of muscle tone
- distorted perceptions (hypnagogic hallucinations),
- inability to move or talk (sleep paralysis).
include disturbed nocturnal sleep and automatic behavior (patients carry out certain actions without conscious awareness). A 2014 study in
the Journal of Sleep
Medicine also reported that nightmares may be more
prevalent in people with narcolepsy than in the general population. All the symptoms
of narcolepsy may be present in various combinations and degrees of
Narcolepsy usually begins in teenagers or young adults and affects both sexes
equally. The first symptom of narcolepsy to appear is excessive
daytime sleepiness, which may remain unrecognized for a long time in that it develops gradually over
time. The other symptoms can follow excessive daytime
sleepiness by months or years. Cataplexy may appear before symptoms of narcolepsy.
Medically Reviewed by a Doctor on 10/6/2016